Abstract
Many inflammatory rheumatic diseases, including rheumatoid arthritis, appear to depend on a dysregulation of the immune system, that is, interference with pathogenetically important immune reactions can be expected to have beneficial or even direct curative effects on the respective diseases. Ideally, an adequate therapy would thus require knowledge of which immune reactions are critical for disease development and access to means whereby these but no other reactions could be down-regulated. Even if we are far from this situation both as to pathogenetic knowledge and access of practically working specific immunomodulatory treatment, our emerging knowledge on the immunopathogenesis of rheumatic joint diseases may be used both to reconsider the mode of action of currently used drugs and to critically approach some of the more experimental treatments that have recently been introduced.
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References
Abramson, S. B., and Weissman, G., 1989, The mechanisms of nonsteroidal antiinflammatory drugs, Arthritis Rheum. 32:1.
Arend, W., and Dayer, J. M., 1990, Cytokines and cytokine inhibitors or antagonists in rheumatoid arthritis, Arthritis Rheum. 33:305.
Benjamin, R. J., and Waldmann, H., 1986, Induction of tolerance by monoclonal antibody therapy, Nature 320:449.
Berg, K. J., Förre, Ö., Djöseland, O., Mikkelsen, M., Narverud, J., and Rugstad, H. E., 1989, Renal side effects of high and low cyclosporin A doses in patients with rheumatoid arthritis, Clin. Nephrol 31:232.
Bettens, E., Kristensen, E., Walker, C., et al., 1984. Lymphokine regulation of activated lymphocytes. II Glucocorticoid anti-Tac induced inhibition of human T lymphocyte proliferation, J. Immunol 132:261.
Bird, H. A., Dixon, J. S., Pickup, M. E., et al., 1980, A biochemical assessment of sulphasalazine in rheumatoid arthritis, J. Rheumatol. 9:36.
Burmester, G. R., Yu, D. T. Y., Irani, A. M., Kunkel, H. K., and Winchester, R. J., 1982, Ia+ T cells in synovial fluid and synovial tissue of patients with rheumatoid arthritis, Arthritis Rheum. 24:1370.
Carson, D. A., Chen, P. P., Fox, R. I., Kipps, T. J., Jirik, E., Goldfie, R. D., Silverman, G., Radoux, V, and Fong, S., 1987, Rheumatoid factors and immune networks, Annu. Rev. Immunol. 5:85.
Chawalinska-Sodowska, H., and Baum, J., 1976, The effects of D-penicillamin on polymorphonuclear leucocyte reactions, J. Clin. Invest. 58:871.
Comer, S. S., and Jasin, H. E., 1986, In vitro immunomodulatory effects of sulfasalazine and its metabolites, Arthritis Rheum. 29:79.
Cush, J. J., Jasin, H. E., Johnson, R., and Lipsky, P. E., 1990, Relationship between clinical efficacy and laboratory correlates of inflammatory and immunologie activity in rheumatoid arthritis patients treated with nonsteroidal anti-inflammatory drugs, Arthritis Rheum. 33:623.
Dallman, M. J., Montgomery, R. A., Larsen, C. P., Wanders, A., and Wells, A. E., 1991, Cytokine gene expression: Analysis using Northern blotting, polymerase chain reaction and in situ hybridization, Immunol Rev. 119:5.
Elliott, J. E., Lin, Y, Mizel, S. B., Bleackley, R. C., Harnish, D. G., and Petkau, V, 1984, Induction of interleukin 2 mRNA inhibited by cyclosporin A, Science 226:1439.
Feltelius, N., Gudmundsson, S., Wennersten, L., Sjöberg, O., Hällgren, R., and Klareskog, L., 1991, Enumeration of IgA-producing cells by the ELISPOT technique in evaluation of sulphasalazine effects in inflammatory arthritides, Ann. Rheum. Dis. 50:369.
Förre, Ö., Bjerkhoel, E., Salvesen, C., Berg, K., Rugstad, H., Saelid, G., Mellbye, O., and Kass, E., 1987, An open, controlled, randomized comparison of cyclosporin and azathioprine in the treatment of rheumatoid arthritis: A preliminary report, Arthritis Rheum. 30:88.
Gerrard, T. L., Cupps, T. R., Jurgensen, C. H., et al., 1984, Hydrocortisone mediated inhibition of monocyte antigen presentation: Dissociation of inhibitory effects and expression of DR antigens, Cell. Immunol 84:311.
Hassan, J., Hanley, J., Gresnihan, B., Feighery, C., and Whelan, C. A., 1986, The immunological consequences of gold therapy: A prospective study in patients with rheumatoid arthritis, Clin. Exp. Immunol 63:614.
Herzog, C., Walker, C., Muller, W., Rieber, P., Reiter, C., Reithmuller, G., Wassmer, P., Stockinger, H., Madic, O., and Pichler, W. J., 1989, Anti-CD4 antibody treatment of patients with rheumatoid arthritis I. Effect on clinical course and circulating T cells, J. Autoimmun. 2:627.
Highton, J., Panayi, G. S., and Griffin, J., 1980, Cellular aspects of anti-rheumatic agents. Improvement in peripheral blood lymphocyte responses to concavalin A and pokeweed mitogen during gold treatment of rheumatoid arthritis, Agents Actions 7:508.
Homewood, C. A., Warhurst, D. C., Peters, W., et al., 1972, Lysosomes, pH and the antimalarial action of chloroquine, Nature 235:50.
Kaibara, N., Hotokebuchi, T., Tagahishi, K., and Katsuki, I., 1983, Paradoxical effects of cyclosporin A on collagen arthritis in rats, J. Exp. Med. 158:2007.
Karlsson-Parra, A., Svenson, K., Hällgren, R., Klareskog, L., and Forsum, U., 1986, Peripheral blood T-lymphocyte subsets in active rheumatoid arthritis patients—effects of different therapies on previously untreated patients, J. Rheumatol 13:263.
Klareskog, L., 1989, What can we learn about rheumatoid arthritis from animal models? Springer Sem. Immunopathol 11:315.
Klareskog, L., and Wigzell, H., 1988, Immune reactions in the rheumatoid synovial tissue, in: Immunopathogenic Mechanisms of Arthritis (J. Goodacre and D. W. Carson, eds.), MTP Press, London, pp. 143–156.
Klareskog, L., Forsum, U., Scheynius, A., Kabelitz, D., and Wigren, A., 1981, Appearance ofanti-HLA-DR reactive cells in normal and rheumatoid synovial tissue, Scand. J. Immunol. 14:183.
Klareskog, L., Holmdahl, R., Rubin, K., Victorin, Å., and Lindgren, J. Å., 1985, Different populations of rheumatoid adherent cells mediate activation vs. suppression of T lymphocyte proliferation, Arthritis Rheum. 28:863.
Klareskog, L., Holmdahl, R., Goldschmidt, T., and Björk, J., 1987, Immunoregulation in arthritis. A review on synovial immune reactions in RA and in some experimental animal models for arthritis, Scand. J. Rheumatol. 64:7.
Krane, S. M., Dayer, J. M., and Goldring, S. R., 1982, Considerations of possible cellular events in the destructive synovial lesion of rheumatoid arthritis, Adv. Inflam. Res. 3:1.
Kremer, J. M., Lawrence, D A., Jubiz, W., DiGiacomo, R., Rynes, R., Bartholomew, L. E., and Sherman, M., 1990, Dietary fish oil and olive oil supplementation in patients with rheumatoid arthritis, Arthritis Rheum. 33:810.
Lee, K. C., Wong, M., and Spitzer, D., 1982, Chloroquine as a probe for antigen processing by accessory cells, Transplantation 34:150.
Lipsky, P. E., 1984, Immunosuppression by D-penicillamin in vitro. Inhibition of human T lymphocyte proliferation by copper or ceruloplasmin-dependent generation of hydrogen peroxide and protection of monocytes, J. Clin. Invest. 73:53.
Lipsky, P. E., and Ziff, M., 1977, Inhibition of antigen-and mitogen-induced human lymphocyte proliferation by gold compounds, J. Clin. Invest. 59:455.
Maksymowych, W., and Russell, A. S., 1987, Antimalarials in rheumatology: Efficacy and safety, Sem. Arthritis Rheum. 16:206.
Nechay, B. R., 1980, Inhibition of adenosine triphosphatases by gold, Arthritis Rheum. 23:460.
Nowell, J., and Quaranta, J., 1985, Chloroquine effects biosynthesis of la molecules by inhibiting dissociation of invariant chain from αβ dimers in B cells, J. Exp. Med. 162:1371.
Papaioannou, M., Fishbein, D. B., Dresen, D. W., Schwartz, I. K., Campbeu, G. H., Sumner, J. W., Patchen, L. C., and Brown, W. J., 1986, Antibody response to preexposure to human diploid-cell rabies vaccine given concurrently with chloroquine, N. Engl. J. Med. 314:280.
Paulus, H. E., 1990, The use of combinations of disease-modifying antirheumatic agents in rheumatoid arthritis, Arthritis Rheum. 33:113.
Phadke, K., Carroll, J., and Nanda, S., 1982, Effects of various anti-inflammatory drugs on type II collagen-induced arthritis in rats, Clin. Exp. Immunol. 47:579.
Pinals, R. S., 1988, Sulfasalazine in the rheumatic disease, Sem. Arthritis Rheum. 17:246.
Ranges, G., Sririam, S., and Cooper, S. M., 1985, Prevention of type II collagen-induced arthritis by in vivo treatment with anti-L3T4, J. Exp. Med. 162:1105.
Scheinberg, M. A., Santos, L. M. B., and Finkelstein, A. E., 1982, The effect of auranofin and sodium aurothiomalate on peripheral blood monocytes, J. Rheumatol. 9:366.
Segal, R., Yaron, M., and Tartakovsky, B., 1990, Methotrexate: Mechanisms of action in rheumatoid arthritis, Sem. Arthritis Rheum. 20:190.
Selhub, J., Dhra, G. J., and Rosenberg, I. H., 1978, Inhibition of folate enzymes by sulphasalazine, J. Clin. Invest. 61:221.
Siegel, R. C., 1977, Collagen cross-linking. Effect of D-penicillamin on cross-linking in vitro, J. Biol. Chem. 252:254.
Slameron, G., and Lipsky, P. E., 1983, Modulation of human immune responsiveness in vitro by auranofin, J. Rheumatol 9:30.
Svartz, N., 1948, The treatment of rheumatic polyarthritis with acid azo compounds, Rheumatism 4:56.
Tugwell, P., Bombardier, C., Gent, M., Bennett, K. J., Bensen, W. G., Carette, S., Chalmers, A., Esdaile, J. M., Klinkhoff, A. V, Kraag, G. R., Ludwin, D., and Roberts, R. S., 1990, Low-dose cyclosporin versus placebo in patients with rheumatoid arthritis, Lancet 335:1051.
Walker, C., Herzog, C., Riber, P., Riethmuller, G., Muller, W., and Pichler, W. J., 1989, Anti CD4 antibody treatment of patients with rheumatoid arthritis II. Effect of in vivo treatment on in vitro proliferative response of CD4 positive cells, J. Autoimmun. 2:643.
Walters, M. T., Smith, J. L., Moore, K., Evans, P. R., and Cawley, M. I. D., 1987, An investigation of the action of disease modifying antirheumatic drugs on the rheumatoid synovial membrane: Reduction in T lymphocyte subpopulations and HLA-DP and DQ antigen expression after gold or penicillamine therapy, Ann. Rheum. Dis. 46:7.
Weinblatt, M. E., Coblyn, J. S., and Fraser, P. A., 1987, Cyclosporin A treatment of refractory rheumatoid arthritis, Arthritis Rheum. 30:11.
Weiss, M., 1989, Corticosteroids in rheumatoid arthritis, Sem. Arthritis Rheum. 19:9.
Yunus, M., 1988, Investigational therapy in rheumatoid arthritis. A critical review, Sem. Arthritis Rheum. 17:163.
Ziff, M., 1990, The rheumatoid nodule, Arthritis Rheum. 33:761.
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Klareskog, L. (1992). Mechanisms Involved in Immunomodulatory Treatment of Rheumatoid Arthritis. In: Rugstad, H.E., Endresen, L., Førre, Ø. (eds) Immunopharmacology in Autoimmune Diseases and Transplantation. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-1167-4_29
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DOI: https://doi.org/10.1007/978-1-4899-1167-4_29
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